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Association of late neonatal sepsis with delayed neurodevelopment in the first two years of life of very low birth weight preterm newborns.
MedLine Citation:
PMID:  24148798     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective to establish the influence of late-onset sepsis on the neurodevelopment of preterm very low birth weight (VLBW) newborns (NBs) according to the etiological agent. Methods Cohort of NBs with birth weight < 1,500g and gestational age < 32 weeks, admitted to the ICU of the institution within 48hours of life, and attended to at the VLBW outpatient clinic for up to two years of corrected age. The following were excluded: death in the first 72h of life, congenital malformations and genetic syndromes, children of HIV-positive mothers and congenital infection, presence of early sepsis, and cases with more than one microorganism identified in blood cultures. Septic and non-septic NBs were compared regarding neonatal outcomes, mortality, and neurodevelopment assessed using the Bayley Scales (BSDI-II) at 18-24 months of corrected age. Results A total of 411 VLBW preterm NBs were eligible, with gestational age = 29±2.2 weeks and birth weight = 1,041±281g. Late sepsis occurred in 94 cases (22.8%). VLBW NBs with infection caused by Gram-positive microorganisms presented motor delay when compared with the group without sepsis - 68.8% vs. 29.3% (95% CI: 1.6 to 21.8, p = 0.006), and cognitive delay was similar. Overall mortality rate from infection was 26.7%; and mortality rates by microorganism group were: coagulase-negative Staphylococcus, 18.7%; Gram-positive, 21.8%; Gram-negative and fungi, 50%. Conclusion Neonatal sepsis has a significant influence on neurodevelopment delay at two years of corrected age in VLBW preterm NBs, and Gram-positive infections are associated with motor delay.
Authors:
Cláudia Regina Hentges; Rita de Cássia Silveira; Renato Soibelmann Procianoy; Clarissa Gutierrez Carvalho; Gabriela Ribeiro Filipouski; Rubia Nascimento Fuentefria; Fernanda Marquezotti; Ana Carolina Terrazan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-19
Journal Detail:
Title:  Jornal de pediatria     Volume:  -     ISSN:  1678-4782     ISO Abbreviation:  J Pediatr (Rio J)     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985188R     Medline TA:  J Pediatr (Rio J)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.
Affiliation:
Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
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